Healthcare Provider Details

I. General information

NPI: 1174242788
Provider Name (Legal Business Name): PRECISION HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9387 S OLD STATE RD STE 1
LEWIS CENTER OH
43035-8448
US

IV. Provider business mailing address

5830 E 2ND ST STE 70005671
CASPER WY
82609-4308
US

V. Phone/Fax

Practice location:
  • Phone: 614-858-8922
  • Fax: 614-785-9375
Mailing address:
  • Phone: 614-483-8595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MISS CHRISTINE A SELAM
Title or Position: DOCTOR OF NURSING PRACTICE
Credential: DNP
Phone: 614-483-8595